1. Technical Field
The present invention pertains to the field of endotracheal intubation.
2. Related Art
Endotracheal intubation is a procedure for creating an artificial airway in a patient by inserting an endotracheal tube (“ETT”) into a patient's trachea through the patient's nose or mouth.
Fiberoptic endotracheal intubation is an intubation technique that utilizes a fiberoptic endoscope (“fiberscope”) to facilitate the proper placement or exchange of an ETT. A health care provider, using the direct visualization provided by the eyepiece of the fiberscope, directs the fiberscope, with an ETT pre-loaded (“piggy-backed”) on the fiberscope's insertion cord, into a patient's trachea. Using the fiberscope as a guide wire, a distal tip of the ETT is then advanced over the fiberscope into the trachea between and beyond the vocal cords.
In an endotracheal tube exchange, an in-place ETT in a patient is withdrawn over a tube exchanger that serves as a guide wire for its removal, and a fresh ETT is thereafter inserted into the patient's airway, by advancement over the tube exchanger, so that its distal tip passes between and beyond the vocal cords.
When an ETT is advanced over the fiberscope or a tube exchanger, the distal tip of the ETT may impinge on the glottis, the epiglottis, the larynx, or other anatomy of the airway, causing trauma and resisting further advancement into the trachea. The impingement of the ETT on the glottis, the epiglottis or the larynx has been attributed to a cleft that arises between the outer ETT that is concentric with either the inner guiding fiberscope or the inner guiding tube exchanger, over which the ETT rides. As the ETT is advanced along the fiberscope or tube exchanger, the cleft between them also advances, with a propensity for snaring tissues lying in its path.
The present invention minimizes the risk of trauma to tissues in the course of fiberoptic intubation and ETT exchange by covering the offending cleft with an a traumatic, flexible shroud.
The present invention also protects the vocal cords from trauma as the ETT is passed between them, particularly when vocal cord edema or mild stenosis is present, in both fiberoptic intubation and intubation performed with or without a laryngoscope to facilitate placement or exchange of an ETT.
The present invention additionally offers advantages in both fiberoptic intubation and intubation performed with or without a laryngoscope to facilitate placement or exchange of an ETT, because of a streamlining effect created by the shroud that facilitates smooth insertion of the ETT. This advantage is especially important in difficult intubations when airway visibility is poor or when the opening between vocal cords through which the ETT must pass is very small.